肌少症对冠心病患者心肌结构影响的研究

The Study for the Effect of Sarcopenia on the Myocardial Structure in Patients with Coronary Heart Disease

目的研究冠心病患者是否合并肌少症的心肌结构和功能的差异,探讨肌少症对冠心病患者心机结构的影响。方法选取2022年6月—2022年12月在青岛大学医学院松山医院住院的122例冠心病患者作为研究对象,应用双能量X射线吸收法(DXA)检测骨骼肌有关参数,使用超声心动图(UCG)检测心脏相关参数,使用多元逐步回归法分析袭击结构与骨骼肌的有关参数的相关关系。结果冠心病伴肌少症患者的左心室质量(LVM)、左室舒张末内径(LVDd)均显著低于非肌少症患者(t=-2.272,P=0.025;t=-3.929,P<0.001);肌少症患者相对室壁厚度(Relative wall thickness,RWT)RWT显著高于非肌少症患者(t=2.232,P=0.035)。逐步回归分析显示,腰围(WC)和下肢骨骼肌质量(LSMM)与LVDd(r=0.181,P<0.001;r=0.319,P<0.020)和LVM(r=1.620,P<0.001;r=2.141,P=0.020)呈正相关。结论肌少症可能引起冠心病患者左心室质量水平和左室舒张末内径的显著降低,其机制有待深入研究。

Objective To compare the myocardial structure diff erences between the patients coronary heart disease(CHD)with or without sarcopenia,so to explore the eff ect of sarcopenia on the myocardial structure of CHD.Methods Selected 122 CHD patients who were hospitalized in the Department of Cardiology,Songshan Hospital of Qingdao Medical College from June 2022 to December 2022.Dual-emission X-ray absorptiometry and ultrasonic cardiography were used to detect the patient's skeletal muscle and heart-related parameters.Multivariate stepwise regression was applied to analysis the relationship between myocardial structure and skeletal muscle related parameters.Results The left ventricular mass(LVM)and left ventricular end diastolic dimension(LVDd)of CHD patients with sarcopenia was significantly lower than those of non-sarcopenia patients(t=-2.272,P=0.025;t=-3.929,P<0.001)while the relative wall thickness(RWT)of CHD patients with sarcopenia was significantly higher than that of non-sarcopenia patients(t=2.232,P=0.035).Stepwise regression show that waist circumference(WC)and lower-limb skeletal muscle mass(LSMM)were positively related to the LVDd(r=0.181,P<0.001;r=0.320,P<0.020)and LVM(r=1.62,P<0.001;r=2.14,P=0.020).Conclusion Sarcopenia might significantly indice the decreases of the LVDd and LVM in CHD patientsa,which the mechanism still needs to be further studied.